Scholarlink

Purpose <p>This multicenter study aimed to identify risk factors for postoperative complications following tubularized incised plate urethroplasty (TIP) in hypospadias patients and develop a clinical prediction model.</p> Methods <p>Retrospective data from 17 tertiary centers (2018–2021) were analyzed. Inclusion criteria: primary TIP surgery with complete anatomical and follow-up data. Exclusion criteria: prior urethral surgery, genetic disorders, or incomplete records. Multivariate logistic regression identified independent predictors. A nomogram model was constructed and internally validated using bootstrapping (1000 resamples). Discrimination (AUC) and calibration (Hosmer–Lemeshow test) were assessed.</p> Results <p>Among 493 patients (median follow-up: 42&#xa0;months), the complication rate was 23.7% (117/493), including urethrocutaneous fistula (17.6%), stricture (6.5%), and diverticulum (2.8%). Independent predictors were:&#xa0;post-incision urethral plate width&#xa0;(OR: 0.01, 95% CI 0–0.05),&#xa0;glans width&#xa0;(OR: 0.81, 95% CI 0.66–0.98), and&#xa0;urethral defect length&#xa0;(OR: 1.47, 95% CI 1.00–2.16). The nomogram demonstrated moderate discrimination (AUC: 0.723, 95% CI 0.668–0.777) and good calibration (Hosmer–Lemeshow&#xa0;P = 0.382).</p> Conclusion <p>A clinical prediction model incorporating post-incision urethral plate width, glans width, and urethral defect length showed acceptable predictive accuracy for TIP complications.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Development of a clinical prediction model for postoperative complications following tubularized incised plate urethroplasty: a multicenter study

  • 期刊论文

  • 发表日期：

    2025年4月8日

查看全文
  • YiWei Fang,
  • Dan Yang,
  • Ning Sun,
  • HongChen Song,
  • WeiPing Zhang,
  • YunMan Tang,
  • LuGang Huang,
  • Yi Yang,
  • Min Chao,
  • Hong Ma,
  • JingTi Zhang,
  • XuHui Zhang,
  • ShouLin Li,
  • Ning Li,
  • Chao Chen,
  • DaWei He,
  • WenBo Wu,
  • Hua Xie,
  • Yong Guan,
  • Yanfang Yang,
  • Jianguo Zhang

摘要

Purpose

This multicenter study aimed to identify risk factors for postoperative complications following tubularized incised plate urethroplasty (TIP) in hypospadias patients and develop a clinical prediction model.

Methods

Retrospective data from 17 tertiary centers (2018–2021) were analyzed. Inclusion criteria: primary TIP surgery with complete anatomical and follow-up data. Exclusion criteria: prior urethral surgery, genetic disorders, or incomplete records. Multivariate logistic regression identified independent predictors. A nomogram model was constructed and internally validated using bootstrapping (1000 resamples). Discrimination (AUC) and calibration (Hosmer–Lemeshow test) were assessed.

Results

Among 493 patients (median follow-up: 42 months), the complication rate was 23.7% (117/493), including urethrocutaneous fistula (17.6%), stricture (6.5%), and diverticulum (2.8%). Independent predictors were: post-incision urethral plate width (OR: 0.01, 95% CI 0–0.05), glans width (OR: 0.81, 95% CI 0.66–0.98), and urethral defect length (OR: 1.47, 95% CI 1.00–2.16). The nomogram demonstrated moderate discrimination (AUC: 0.723, 95% CI 0.668–0.777) and good calibration (Hosmer–Lemeshow P = 0.382).

Conclusion

A clinical prediction model incorporating post-incision urethral plate width, glans width, and urethral defect length showed acceptable predictive accuracy for TIP complications.